title: Promoting heart health in rural women.
abstract: OBJECTIVE
  To compare 2 strategies, stage-matched nursing and community intervention (SMN+CI) and community intervention (CI) alone in changing cardiovascular risk factors in up to 3 behavioral areas: diet, physical activity, and/or smoking among rural women.
  
  
  METHODS
  A 14-month, multisite randomized controlled trial of 117 rural women was conducted. Transtheoretical model was used in identification of stage of change and development of the SMN+CI nursing interventions. A social-ecological model was used to address issues of rurality in the development of interventions.
  
  
  RESULTS
  The SMN + CI group was superior on 4 outcomes. There were significant increases in 2 measures of dietary intake; improvement in dietary stage of change for fruits and vegetables; and reduced diastolic blood pressure (DBP) in the SMN + CI group. After log transformation DBP significance was lost. The CI group had a significant reduction in change in total cholesterol; however, significance was lost after control for the initiation of lipid lowering medications. There was a significant reduction in Framingham risk scores pre- to postintervention, regardless of group.
  
  
  CONCLUSIONS
  There continues to be a need to improve cardiovascular risk factors in rural women. There should be an exploration of whether intensified dose and fidelity of the intervention strategies of diet and physical activity are effective in improving anthropometric and laboratory values. Further investigation is warranted into factors influencing the pre- to postreduction in Framingham risk scores.
authors.affiliation: Decker School of Nursing, Binghamton University, State University of New York, Binghamton, New York 13902-6000, USA. psfahs@binghamton.edu
authors.forename: Pamela Stewart
authors.initials: PS
authors.lastname: Fahs
authors.forename: Margaret
authors.initials: M
authors.lastname: Pribulick
authors.forename: Ishan Canty
authors.initials: IC
authors.lastname: Williams
authors.forename: Gary D
authors.initials: GD
authors.lastname: James
authors.forename: Virginia
authors.initials: V
authors.lastname: Rovnyak
authors.forename: Virginia
authors.initials: V
authors.lastname: Rovynak
authors.forename: Susan M
authors.initials: SM
authors.lastname: Seibold-Simpson
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006306:Health Surveys; D006801:Humans; D008875:Middle Aged; D008962:Models, Theoretical; D040242:Risk Reduction Behavior; D012424:Rural Population; D014481:United States